Monday, September 30, 2013

Chances of getting a donor kidney in Hong Kong as low as 5 per cent

Hong Kong faces a severe continuing shortfall in kidney donors that is leaving many people in need of transplants with little or no chance of receiving one.

Hospital Authority figures showed 1,892 people were waiting for a kidney transplant as of June 30, and that only 99 received one last year. That means only around 5 per cent of those on the waiting list receive one.

Manesh Samtani is one of the lucky few, having finally received a kidney transplant seven months ago after a five-year wait.

His family members have had kidney problems for generations, and he was on daily dialysis in hospital for the duration of his wait. Samtani, 31, says the transplant changed his life.

"The problem is that when someone in Hong Kong passes away, no one knows what their wishes were before they died," he said. "The donation register is not obvious or accessible enough. People aren't made aware of the donation process."

The IT consultant attributed Hong Kong's low organ donation rates to weak social awareness, inadequate education, a lack of promotion on the need for organ donors, and traditional Chinese beliefs about the preservation of an intact body after death.

Many bereaved families have also cited an unwillingness to donate organs because the wishes of the deceased had never been discussed while they were alive. In some countries, people are asked whether they would like to become an organ donor when they are issued with a driving licence. That means the individual makes the decision on the spot, which has been proven to boost the number of donors.

The wait is even worse for asylum seekers. One 37-year-old man from the Democratic Republic of Congo who has been living in Hong Kong for 10 years has been on peritoneal dialysis for the past two years. But he is not on the transplant waiting list because only Hong Kong residents are eligible.

The Department of Health denies it is providing too little information to potential donors, saying it established the Centralized Organ Donation Register in November 2008 to provide multiple channels, including internet, e-mail and fax, to more conveniently allow people to register their wish to donate their organs after death.

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Ohio Nurses Surprise Lung Transplant Couple With Hospital Wedding

Nurses even created a sign for the back of Smith's wheelchair: "He got his lungs, she got his heart."

Doug Smith, a police officer with life-threatening pulmonary fibrosis, was one week away from his wedding day last June when he got the 1:30 a.m. call that a donor lung had become available for transplant.

The Zanesville, Ohio, 42-year-old had never smoked and had been healthy for 20 years, but in 2011, asthma-like symptoms made it almost impossible for him to breathe. With no effective therapies, he was put on a transplant list.

"I was tired all the time," said Smith, who worked the night shift at the jail in town. "I was doing six liters of oxygen a day. "My body had started to go pretty quick."

The couple, each of them married before and with three teenage children between them, had been dating for five years and had planned a small, quick church ceremony because they worried about his precarious health.

Typically, those with this disease only live about two to five years after diagnosis.

Wedding plans were dashed, and within days of the call from Cleveland Clinic's Transplant Center, Smith was in surgery.

But one month to the day after getting a new lung, on June 21, Smith and his now wife, Susan, tied the knot on the rooftop of the hospital before family and staff.

Doug Smith had been transferred to the recovery floor, and his bride to be had cleared the on-site marriage with the hospital chaplain, but the rest was a complete surprise.

"The next thing you know there was a roomful of nurses with pen and paper, running in and out of the room, deciding among themselves that they would take care of everything," said the prospective bride, 46. "It was amazing -- they were so excited. It was very emotional."

"We had joked before about getting married in Cleveland," she said, which was more than two hours away from their home.

"We already had the marriage license and it was going to expire," said Susan Smith. "Forty bucks is forty bucks, especially with finances going against us."

The staff provided a bouquet of daisies, her favorite flowers, and one nurse even provided her own veil. Another, who was a consultant for the cosmetics company Mary Kay, rolled in a big suitcase of make-up.

Nurses even created a sign for the back of Smith's wheelchair: "He got his lungs, she got his heart."

"I had a cute little white dress and that was plenty good enough," said Susan Smith. "I was in flip-flops because my daughter forgot to bring shoes."

"They all brought food donated by Starbucks and Au Bon Pain," she said. "They even provided a cake -- something I had never thought of. One of the nurses said, 'You are not getting married in the room. We are taking you up to the rooftop.'"

Doug Smith was fortunate to get a new lung and even luckier to make it through grueling surgery and a two-month hospital stay to make sure he did not reject the organ.

"He had a tough transplant," said Dr. Marie Budev, medical director of Cleveland Clinic's Lung Transplantation Program. "He had some issues with primary graft dysfunction. His lungs got wet and he had to remain on a ventilator for a while. "He's been through a lot."

The survival rate is about 53 percent after a lung transplant, but Smith's youth may make his odds better.

"If they are younger and their other organs are younger, they are able to sustain a lot of the toxic effects from the immune suppressive drugs they are on for the rest of their life," said Budev. "We do have patients 20 years out -- they are a small fraction, but everyone has that potential," she said.

Though Budev was overseas when the Smiths were eventually married, she said the hospital staff had been "inspired" by the couple.

"We had never had a wedding after a transplant like this -- it was special for us," she said. "Despite the terrible things that happen, life goes on."

The Smiths say that Doug's brush with death underscores the scarcity of organ donors that requires the average American to wait six to nine months for a transplant.

Pulmonary fibrosis, an insidious disease that scars the tissues in the lungs and responds poorly to medication, accounts for about half of all lung transplants performed at the Cleveland Clinic.

A recent study estimates that about 500,000 Americans suffer from the disease, most with no known causes, according to the Pulmonary Fibrosis Foundation.

"The decline is rapid, and it is an unpredictable and relentless disease," said Budev. "You can have coughing, or is it dismissed as asthma and after an X-ray a workup is done, and you can see the abnormal pulmonary function. They are short of breath and have exercise intolerance and the ability to do tasks is difficult, but symptoms can get much more severe."

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I can certainly relate to Doug Smith's ordeal with pulmonary fibrosis.

I was diagnosed with Idiopathic (unknown cause) Pulmonary Fibrosis or IPF and eventually received a single-lung transplant almost 12 years ago.

It certainly is a debilitating disease because the scarring of lung tissue caused by PF causes fibrosis of the alveolar epithelial cells where oxygen is transferred to the blood stream. Lack of oxygen to vital organs such as the heart and brain causes weakness and fatigue making it difficult to function. I can remember not being able to bend over to tie my own shoes, even when connected to an oxygen tank.

So far no medications have been able to slow down the progression of pulmonary fibrosis. There are currently no FDA-approved therapies for idiopathic pulmonary fibrosis. The FDA had granted Intermune's drug perfinedone priority review, which is reserved for products that fill an unmet medical need.

The company submitted two studies of its drug to FDA, measuring perfinedone's ability to improve lung function in patients. While one study showed a statistically significant 4.4 percent increase in lung strength, another failed to prove substantially more effective than a placebo. FDA generally requires two clinical trials with positive results before granting approval. Pirfenidone is approved for marketing in 29 European countries and Canada under the InterMune trade name Esbriet® and in Japan and South Korea where it is marketed by Shionogi & Co. Ltd under the trade name Pirespa®. Under different trade names, pirfenidone is also approved for the treatment of IPF in China, India, and Argentina. InterMune is conducting an additional Phase 3 study, ASCEND, to support the regulatory registration of Esbriet for the treatment of IPF in the United States. Merv.

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Thursday, September 26, 2013

TRANSPLANT RECIPIENTS TO 'LIGHT UP THE WORLD'ABOARD DONATE LIFE FLOAT IN 2014 ROSE PARADE FLOAT

Riders from 19 States and Taiwan Thank Their Organ, Tissue and Eye Donorsfor Life-Saving Gifts on World Stage

The 2014 Donate Life Rose Parade Float entry features a festival of lanterns illuminating 30 riders all grateful organ and tissue transplant recipients – and 12 living organ donors walking alongside to demonstrate their ongoing vitality. Five enormous lamps are adorned with 72 memorial floragraph portraits of deceased donors whose legacies of life shine brightly. The riders are seated throughout a dedication garden filled with thousands of roses bearing personal messages of love, hope and remembrance.

LOS ANGELES, Calif. – – Thirty fortunate recipients of organ and tissue transplants will "Light Up the World" with their dramatic and heartrending stories as riders aboard the 11th annual Donate Life float in the 2014 Rose Parade, which reaches tens of millions of viewers across the U.S. and worldwide. Each individual was selected by an organization for their courage, service and advocacy in light of the life-saving transplants they received from generous donors.

The 30 riders range in age from 18 to 77, and hail from 19 states – Arizona, California, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan Missouri, Nebraska, New Jersey, New York, North Carolina, Oklahoma, Pennsylvania, South Carolina, Texas, and Virginia – and Taiwan. Their lives have been affected by a broad spectrum of challenges and salvations, all connected by one common denominator: the gift of life.

"Our float riders have shown what it means to 'Light Up the World' by virtue of their survival and service to their local communities," reflected Bryan Stewart, chairman of the Donate Life Rose Parade Float Committee and vice president of communications at OneLegacy, the nonprofit organ and tissue organization serving the greater Los Angeles area. "We are inspired by the 2014 Rose Parade theme, "Dreams Come True," to spotlight individuals who embody what organ, eye and tissue donation makes possible in the hope that viewers will be inspired to register as donors."

Because the conditions allowing donation to occur are rare, many millions of committed donors are required to help those in need. A single organ donor can save the lives of eight people through organ donation, while a tissue donor can save and heal 50 or more lives through the gifts of heart valves, corneas, skin, bone, and tendons that mend hearts, cure blindness, restore mobility and overcome burns.

"Every single person who takes action to be a donor gives hope to the nearly 120,000 people across America waiting for their dream – a life-saving organ transplant – to come true," said Stewart. "In addition to the lives saved by deceased donors,approximately 6,000 lives per year are saved by living kidney and liver donors."

The Donate Life Rose Parade Float's family of sponsors urges viewers to help make dreams come true for more than one million people in need of life-saving and healing organ, tissue and cornea transplants. Join America's 113 million registered donors so that everyone whose life and livelihood depends on a transplant can have one. Sign up when renewing your driver's license or by visiting www.DonateLifeAmerica.org. Further information about the Donate Life float can be found at www.donatelifefloat.org.

The Pasadena Tournament of Roses is a volunteer organization that annually hosts the Rose Parade® presented by Honda, Rose Bowl Game® presented by VIZIO and various associated events. The 125th Rose Parade presented by Honda, themed "Dreams Come True," will take place Wednesday, Jan. 1, 2014, at 8 a.m. (PST) featuring majestic floral floats, high-stepping equestrian units and spirited marching bands. Following the parade, the 100th Rose Bowl Game presented by VIZIO will kick off at2:10 p.m. and feature an exciting match-up between two of the top collegiate football teams in the nation. For additional information on the Tournament of Roses please visit the official website at www.tournamentofroses.com.

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Monday, September 23, 2013

BUSINESSMAN BURIES BENTLEY IN BACK YARD TO PROMOTE ORGAN DONATION

Many people may have thought that Brazilian businessman Count Scarpa was crazy when he announced that he was burying his luxury Bentley automobile in his back yard.

He dug up his Sao Paulo property with a backhoe, explaining to stunned onlookers that he was just mimicking what Egyptian royalty did in order to take their possessions with them into the afterlife. But there is another side to the story, as the 62-year old Scarpa eventually revealed on a social media post.

He explained that he buried his Bentley as a way to show individuals how crazy it is that they bury bodies without donating valuable organs that could be used in transplants to save the lives of others. Scarpa notes that it is actually much more crazy to bury a body containing still usable organs that it is to bury a luxury vehicle.

‘I decided to do as the pharaohs: this week I will bury my favourite car, the Bentley here in the home garden! Bury my treasure in my palace rssss !!!’, the enigmatic 62-year-old wrote on his Facebook page.

He encouraged readers to make arrangements to donate their organs after their death and asked that everyone pass along the same message to friends and family members.

He later wrote on the social network: ‘I buried my car, but everyone thought it was absurd when I said I was going to do that. Absurd is bury their organs, which could save many lives. Nothing is more valuable. Be a donor, tell your family.’

There is no word if Scarpa is planning to dig up his Bentley after getting his organ donation message across and no idea how many people were inspired by his message to donate.

Sunday, September 22, 2013

Most lung transplant patients and their families are faced with financial hardships before, during and following their surgery. In addition to loss of income because of inability to continue working, they must maintain their home residences and face double living expenses because they must live near their transplant center while waiting for their transplant and during the three-month follow-up. I salute the Trail Riders for this very successful project which will greatly help patients and families.

A group of lung transplant recipients hit the trail to raise $55,000 for organ transplant patients and their families.

Called the 2nd Chance Trail Ride, the riders gathered near Elk Point, in northeast Alberta, in May.

Riders from the 2nd Chance Trail Ride raised $55,000 to build and furnish an apartment suite to benefit organ transplant patients and their families at the University of Alberta. (CBC)

Double-lung transplant recipient Harvey Nelson was one of the participants in the trail ride.

A lifelong rider, Nelson was forced to quit horseback riding as his health deteriorated. Once he got the transplant, he said his life completely changed.

“It’s given me just a total second chance on life,” he said.

Now, he and his fellow riders are hoping to help others make the same dramatic recovery by donating the funds to theGoodHeartsFoundation.

The foundation will use the cash to build and furnish a new suite near the University of Alberta for transplant patients and their families to use while going through the transplant process, which takes about three months.

“The apartment gives [families] a chance to be here and be with their loved one that is going through the transplant,” said Nelson. “So it makes quite a difference to the families that are doing it.”

In addition to building the apartment, Nelson also hopes the trail-ridersfundraising efforts will help raise awareness about the need for organ donations.

“We need more [organ donations] because there's quite a waiting list for it,” he said.

“It's difficult to go through life when you know you need a transplant and there isn't an organ there for you.“

The U of A hospital is Canada’s biggest and busiest transplant centre.*

*I believe this is a typo and originally meant to say that U of A hospital is Alberta's busiest transplant center, not Canada's. Toronto's University Health Network Multi-Organ Transplant Program is Canada's biggest and busiest, with over 400 organ transplants yearly and follow-up with more than 5,000 patients.

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Friday, September 20, 2013

Further to my recent post about the future possibility of printing human organs for transplant this research gives new insights into the potential of regenerative medicine in easing the shortage of donor organs and ultimately saving more lives.

“Start Quote

It works better than testing on animals”

Dr Anthony AtalaWake Forest Institute for Regenerative Medicine

But the tests being carried out at the Wake Forest Institute for Regenerative Medicine in North Carolina are the first to combine several organs on the same device, which then model the human response to chemical toxins or biologic agents.

The lab-engineered organs are then placed on a 2in (5cm) chip and linked together with a circulating blood substitute, similar to the type used in trauma surgery.

The blood substitute keeps the cells alive and can be used to introduce chemical or biologic agents, as well as potential therapies, into the system.

Sensors which measure real-time temperature, oxygen levels, pH and other factors feed back information on how the organs react and - crucially - how they interact with each other.

Dr Anthony Atala, institute director at Wake Forest and lead investigator on the project, said the technology would be used both to "predict the effects of chemical and biologic agents and to test the effectiveness of potential treatments".

"You are actually testing human tissue," he explained.

"It works better than testing on animals."

Anti-terrorism

A group of experts from around the US is involved in putting together the technology, which will carry out toxicity testing and identification.

Miniature tissue samples can be exposed to toxins as well as potential treatments

The funding for the project was awarded by the Defense Threat Reduction Agency (DTRA), a division of the US government which combats nuclear, chemical and biological weapons.

The tests being carried out at Wake Forest "would significantly decrease the time and cost needed to develop medical countermeasures" for bioterrorism attacks, said Dr Clint Florence, acting branch chief of vaccines within the Translational Medical Division at DTRA.

Wake Forest said it was able to test for antidotes to sarin gas, recently used against civilians in Syria.

Printed house

Dr Atala, whose field is regenerative medicine, said the bioprinting technology was first used at Wake Forest for building tissues and organs for replacement in patients.

His team had managed to replicate flat organs, such as skin, tubular organs such as blood vessels, and even hollow non-tubular organs like the bladder and the stomach, which have more complex structures and functions.

But building solid organs like the heart and the liver is the hardest challenge yet.

It takes about 30 minutes just to print a miniature kidney or heart, which is the size of a small biscuit.

"There are so many cells per centimetre that making a big organ is quite complex," Dr Atala told the BBC.

But the bioprinting of full size solid organs might not be far away.

"We are working on creating solid organ implants," said Dr Atala.

A combination microscope and incubator is used to image tissue over time

Bioink containing various types of cell is printed into moulds made from agarose gel.

Thursday, September 19, 2013

Source Newsroom:Houston Methodist ; Newswise — Tiffany Schwantes was going to die without a new liver. The 31-year old mother of two suffered from an aggressive form of liver cancer and, because of organ allocation rules, she could not be placed high enough on the liver transplant list to receive a new liver in a timely manner. Surgeons at Houston Methodist Hospital and her oncologist at the University of Texas MD Anderson Cancer Center determined that the only way to save her life was a domino transplant.“This is a rarely performed and complicated procedure that would allow her to receive a new liver from a living donor,” said R. Mark Ghobrial, M.D., director of the Center for Liver Disease and Transplantation at Houston Methodist Hospital. The majority of patients with her type of cancer, cholangiocarcinoma, never receive a transplant, but Schwantes’ case was different.

“She was young and her tumor was responding to chemotherapy for a sustained duration,” said Milind Javle, M.D., an MD Anderson GI oncologist. “Because of her positive response to treatment I was able to refer her to the Houston Methodist liver transplant team.”

Tiffany was on what is called the ‘out-of-criteria’ list. Her liver was not sick enough for her to receive one from the normal donor pool where recipients are chosen by their degree of illness, said Howard Monsour, M.D., chief of hepatology at Houston Methodist Hospital. “If we would have waited for her liver to deteriorate, her cancer would have spread and she would have never made it.”

Meanwhile, 60-year old Vernon Roberson was suffering from amyloidosis, a genetic blood disease that attacks and destroys organs such as the heart, liver, kidneys, etc. He was progressively getting worse and was in need of a heart and liver transplant. When the organs became available this past July, surgeons asked him if he would be okay with donating his liver to Schwantes.“I told them if I can save someone’s life, I am all for it,” Roberson said.

“While the diseased liver was not working for Mr. Roberson, we determined it was a viable organ for Tiffany,” Ghobrial said. “It will take her 20 to 30 years to develop amyloidosis, if at all, and if that occurs she can get another liver transplant. This was really the only option for saving her life.”Ghobrial says more precision is necessary for this surgery than a standard liver transplant because blood flow to the organ must be preserved to keep it viable for the recipient. During a normal procedure, the liver is removed and discarded. The 12-hour plus procedure involved a large transplant team that included four liver surgeons, two cardiac surgeons, two anesthesia teams, a perfusion team, transplant coordinators and at least 10 nurses.“This is the first domino transplant we have ever done at Houston Methodist Hospital. It’s a very rare procedure, but I think the shortage of organs will cause us to look at doing more in the future,” Ghobrial said.

“There’s been a national push to use more of these so-called ‘marginal’ organs,” Monsour said. “We have a great joint program with MD Anderson where they are referring more of these patients like Tiffany to us for evaluation. I think if we can catch these cancers early, I believe we can save many more lives by performing domino transplants.”Roberson is on the road to recovery in Houston and Schwantes is back home in Alabama enjoying life with her husband and children.

“This is a wonderful example of collaboration between different institutions to provide innovative approaches to betterment of human life,” Ghobrial said. “Thinking outside the box, we all helped prolong the life of a young wife and mother. That’s what makes this job so great.”

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Wednesday, September 18, 2013

By Amber RockliffeReporter, Global TorontoSASKATOON, Canada – Less than a year ago, Terry Shrader could barely make it from his house to his car. On Sunday, he ran five kilometres with a new heart. The transplant recipient said he’s incredibly grateful. “It’s incredible,” said Shrader.

“Now I’m in the field house every morning, I’m on the treadmill, I’m on the elliptical,”

Twelve years ago, Shrader had breathing problems. His wife is a nurse, and she prompted him to go to their family doctor.

“He took an x-ray and showed us the x-ray and my heart was two times the size of a normal heart. And he says ‘you’ll probably need a heart transplant’,” Shrader explained.

Shrader had never been a sick person before the news. Doctors told him his condition was caused by a virus.

“When talking to people who’ve had this, that’s where most of them are, they just pick up viruses, like a cold virus,” said Shrader.

After years of suffering, Terry was fortunate enough to get a heart transplant last year. He says he’s one of the lucky ones.

“There are so many people out there that are waiting on a list for an organ,” said Shrader.

“Heart disease is certainly still the number one killer, and the end stage of heart disease is heart failure,” said Saskatoon Cardiologist Jason Orvold.

“Heart disease can be managed but it can’t be cured, and there are a large amount of patients like Terry that are waiting for a heart transplant,” said Orvold.

The second annual Heartbeat Run took place on the Mendel Riverbank. Not only did the run celebrate survivors, but it also encouraged healthy living.

“It’s not hard to do, to get out and walk with your family. We’ve got a beautiful city that we can walk, there’s the Meewasin Trail, there’s so many great places you can go, and it’s easy to be healthy,” said Lisa Bergen, manager of Heart Health Operations at Royal University Hospital.

At the awards ceremony after the race, Terry thanked first and foremost the donor who allowed him to live.

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Tuesday, September 17, 2013

The risk of death following bone marrow transplantation can be reduced about 60 percent using a new technique to identify bone marrow donors who make the most potent cancer-fighting immune cells, according to research from St. Jude Children’s Research Hospital. The findings appear in the September 16 online issue of the Journal of Clinical Oncology.The research builds on an earlier St. Jude discovery that specialized immune cells called natural killer (NK) cells dispatched cancer cells more efficiently when the NK cells carried a particular version of a KIR protein on their surface. KIR is short for killer-cell immunoglobulin-like receptor. KIR proteins regulate NK cells.For this study, researchers reviewed the outcomes of the 313 bone marrow transplants performed at St. Jude during the decade ending in January 2010. Investigators found that patients were far more likely to have survived the transplant and far less likely to have their disease progress if their new bone marrow came from donors whose NK cells included the same version of the protein, rather than the alternative form.“This approach should dramatically improve the outcome for patients undergoing bone marrow transplantation, regardless of their age or underlying condition,” said Wing Leung, M.D., Ph.D., the paper’s corresponding author and chair of the St. Jude Department of Bone Marrow Transplantation and Cellular Therapy. “NK cells also play an important role in autoimmune disorders, chronic infections and other conditions, so these results will likely have an impact beyond cancer.”Transplant patients benefited regardless of their disease, previous treatment, completeness of the genetic match or other donor characteristics, including whether the donor was a relative, Leung said. Screening for the NK cell variation uses blood collected for the current donor screening process and will not slow donor selection.NK cells account for less than 15 percent of white blood cells, but play a major role in defending against cancer and viral infections. This research focused on a protein named KIR2DL1, which belongs to the KIR family of proteins. The KIR2DL1 protein is found on NK cells of nearly all healthy individuals.Proteins are made up of long chains of amino acids. Due to natural genetic variation, there are 25 versions of KIR2DL1, each with a slightly different amino acid sequence.In an earlier study, Leung and his colleagues discovered that NK cells with one of the KIR2DL1 variations killed cancer cells growing in the laboratory more efficiently than NK cells with a different version of the protein. The potent NK cells featured the amino acid arginine at position 245 of KIR2DL1 rather than the amino acid cysteine in that spot. That discovery led to this study, which offers the first proof that the amino acid difference impacts patient outcomes.Researchers checked the outcomes of all bone marrow transplants performed at St. Jude during the 10-year period. They found that donor bone marrow with two copies of the gene for the arginine 245 version of KIR2DL1 was associated with a 60 percent decreased risk of death following transplantation and a 62 percent reduced risk of disease progression compared to transplants with donor bone marrow that carried instructions for making just the cysteine version. The transplants involved patients battling both acute lymphoblastic and acute myeloid leukemia as well as other conditions.St. Jude has patented and licensed a test to identify potential donors with the preferred amino acid. The goal is to make the screening test widely available to other transplant centers as soon as possible, officials said.The study’s first authors are Rafijul Bari of St. Jude and Piya Rujkijyanont, formerly of St. Jude. The other authors are Erin Sullivan, Guolian Kang, Victoria Turner and Kwan Gan, all of St. Jude.The research was supported in part by grants (CA02176524 and CA021765) from the National Institutes of Health, the Assisi Foundation of Memphis and ALSAC.Read the full story at http://www.prweb.com/releases/2013/9/prweb11128583.htm

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